Progress in Antiretroviral Research

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cell Biology and Pathology".

Deadline for manuscript submissions: closed (30 June 2025) | Viewed by 1907

Special Issue Editor


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Guest Editor
Unit of Infectious Diseases, Ospedale Santa Chiara, Trento, Italy
Interests: HIV infection; antiretroviral therapy; opportunistic infections; personalized therapy

Special Issue Information

Dear Colleagues,

Recommended antiretroviral therapy, consisting of two nucleoside analogues and a third agent (integrase inhibitor, non-nucleoside reverse transcriptase inhibitor, or boosted protease inhibitor),  must be taken everyday (7 days/week) for life, with a risk of reduced adherence and long-term toxicity. In recent years, different strategies have been studied to reduce the exposure of people living with HIV (PLWH) to antiretroviral drugs and to improve their adherence and quality of life, while maintaining safety and virological suppression. Long-acting agents used to treat HIV infection will be the future, and cabotegravir and rilpivirine are the first to be used. Meanwhile, “intermittent” or “short-cycle” therapy (SCT) has received considerable attention. This strategy allows PLWH to take their antiretroviral drugs at standard doses and in combination for a limited number of consecutive days (generally 4 or 5 days) per week and interrupt the treatment during the weekend (Friday to Sunday or Saturday to Sunday).

Dr. Massimiliano Lanzafame
Guest Editor

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Keywords

  • antiretroviral therapy
  • short cycle therapy
  • HIV infection
  • long-acting agents

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Published Papers (2 papers)

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Research

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19 pages, 2890 KiB  
Article
Prospective Neuropsychological and Plasma Biomarker Changes in Treatment-Naïve People Living with HIV After Antiretroviral Treatment Initiation
by Charalampos D. Moschopoulos, Evangelia Stanitsa, Konstantinos Protopapas, Akrivi Vatsi, Irene Galani, Henrik Zetterberg, Ion Beratis, Paraskevi C. Fragkou, Sotirios Tsiodras, Dimitra Kavatha, Antonios Papadopoulos, Sokratis G. Papageorgiou and Anastasia Antoniadou
Biomedicines 2025, 13(7), 1704; https://doi.org/10.3390/biomedicines13071704 - 12 Jul 2025
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Abstract
Introduction: Human immunodeficiency virus (HIV)-associated neurocognitive impairment (NCI) remains a concern despite combination antiretroviral therapy (cART), with cognitive problems often persisting even after viral suppression. The mechanisms underlying neurocognitive deterioration in people living with HIV (PLWH) and the role of plasma biomarkers [...] Read more.
Introduction: Human immunodeficiency virus (HIV)-associated neurocognitive impairment (NCI) remains a concern despite combination antiretroviral therapy (cART), with cognitive problems often persisting even after viral suppression. The mechanisms underlying neurocognitive deterioration in people living with HIV (PLWH) and the role of plasma biomarkers remain unclear. This study aims to evaluate neurocognitive trajectories and biomarker changes in a real-world cohort of newly diagnosed PLWH initiating cART in Greece. Methods: This prospective, single-center study assessed neuropsychological performance and plasma biomarkers in treatment-naïve PLWH at baseline and 18 months after cART initiation. HIV-associated neurocognitive disorder (HAND) was classified using the Frascati criteria, and plasma biomarkers of inflammation and monocyte activation were measured. Correlations between biomarkers and cognitive performance were analyzed. Results: A total of 39 treatment-naïve PLWH were enrolled in this study. At baseline, 45.7% of participants met criteria for HAND, predominantly, asymptomatic neurocognitive impairment (ANI). Over 18 months, neurocognitive function improved, particularly in speed of information processing, executive function, and visuospatial ability, while verbal fluency, fine motor dexterity, and attention/working memory remained unchanged. Biomarkers of inflammation and monocyte activation decreased following cART, except for neopterin, which increased (10.6 vs. 13 ng/mL, p = 0.002), and plasma NFL (7.5 vs. 7.2 pg/mL, p = 0.54), which remained stable. A negative correlation between monocyte activation markers and cognitive performance was observed only at follow-up, suggesting that systemic inflammation may mask these associations in untreated PLWH. Conclusions: Early cART initiation supports neurocognitive recovery and reduces immune activation in PLWH. The observed correlation between cognitive performance and monocyte activation markers after viral suppression highlights the potential utility of plasma biomarkers in predicting cognitive impairment. Full article
(This article belongs to the Special Issue Progress in Antiretroviral Research)
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6 pages, 202 KiB  
Brief Report
Short-Cycle Therapy with Bictegravir/Emtricitabine/Tenofovir Alafenamide in a Small Cohort of Virally Suppressed People Living with HIV: A Long-Term Follow-Up
by Massimiliano Lanzafame, Emanuela Lattuada, Andrea Delama, Giovanni Mori and Sandro Vento
Biomedicines 2024, 12(11), 2620; https://doi.org/10.3390/biomedicines12112620 - 15 Nov 2024
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Abstract
Background: Antiretroviral triple therapy has considerably reduced morbidity and mortality in people living with HIV and is the standard-of-care treatment. However, it is lifelong and linked to long-term side effects and adherence problems. Methods: Here, we report long-term virological and immunological outcome in [...] Read more.
Background: Antiretroviral triple therapy has considerably reduced morbidity and mortality in people living with HIV and is the standard-of-care treatment. However, it is lifelong and linked to long-term side effects and adherence problems. Methods: Here, we report long-term virological and immunological outcome in 12 virally suppressed people on short-cycle therapy with bictegravir/emtricitabine/tenofovir alafenamide administered five days a week (Monday to Friday). Results: All patients, after a long term follow-up, were virally suppressed Conclusions: In the wait for new long-acting antiretroviral drugs and new antiretroviral formulations, short-cycle therapy has proven to be a safe and effective alternative to the standard daily antiretroviral regimen for individuals living with HIV who are virologically suppressed. Full article
(This article belongs to the Special Issue Progress in Antiretroviral Research)
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